Point-of-Care Ultrasound in Diagnosis and Treatment of Luxatio Erecta (Inferior Shoulder Dislocation)

BackgroundPoint-of-care-ultrasound (POC-US) is an increasingly popular tool in the assessment of a wide variety of emergency department patients. In this case report we discuss how POC-US aided in the diagnosis and treatment of inferior shoulder dislocation, a rare presentation of a common emergency department complaint.Case ReportA 69-year-old female presented to the emergency department with severe shoulder pain after a ground level fall. Her arm was held overhead with her shoulder trapped in abduction. POC-US confirmed the diagnosis of inferior shoulder dislocation, guided glenohumeral intraarticular anesthesia, and confirmed successful reduction.Why an emergency physician should be aware of this: POC-US is a useful tool for the emergency physician when confronted with shoulder dislocation. US not only confirms the dislocation, but also differentiates between anterior versus posterior versus inferior dislocation. POC-US can guide the placement of intraarticular lidocaine for anesthesia which then potentially reduces time, expense, and risk of procedural sedation. Finally, POC-US may reduce failed reductions by providing immediate visual confirmation and in the case of reductions performed under sedation, may prevent the need for repeat sedation.